Professor Alan Irvine:

In Australia, for example, it is quite common for people to predominantly work in the independent sector and do two or three days per week in the public sector. That is the dominant model in Australia. I am less familiar with the model in Canada but the remuneration, terms and conditions, and supports are different. There is also availability of operating lists, of outpatient suites and of the whole multi-professional support. Doctors are not islands, they work in highly skilled teams. Nurses and other healthcare professionals are essential and have enough support around those also. There are lots of differences around the anglophone countries. North America and Australia are the really only relevant comparators. That is where we tend to lead people. One would need to break it down by region. Certainly, the model in Australia is a very mixed, blended model. The remunerations in the United States of America are just off the scale and we are not going to replicate those necessarily in Ireland. We do, however, have to find our own way to bring people in and that means listening. As I said earlier, we have to listen to people rather than just present them with the take it or leave it option. That has failed and is failing, and it will always continue to fail if we take that approach.